Evidence map›Paper›PMID 40615841›Full record

ArticleBMC surgery2025

The impact of comorbidities on the all-cause mortality of surgically treated non-small cell lung cancer patients - visualization with the aid of a comorbidome.

Julia Zimmermann, Julia Walter, Mircea Gabriel Stoleriu, Julia Kovács, Gökce Yavuz, Fuad Damirov, Niels Reinmuth, Martina Merk, Rudolf A Hatz, Amanda Tufman and 1 more

Abstract read
In one paragraph

Article in BMC surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Guideline
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Julia ZimmermannDivision of Thoracic Surgery, LMU University Hospital, LMU Munich and Asklepios Lung Clinic Gauting, Munich, Germany. Julia.Zimmermann@med.uni-muenchen.de.
Julia WalterDepartment of Internal Medicine V, LMU University Hospital, LMU Munich, Germany.
Mircea Gabriel StoleriuDivision of Thoracic Surgery, LMU University Hospital, LMU Munich and Asklepios Lung Clinic Gauting, Munich, Germany.
Julia KovácsDivision of Thoracic Surgery, LMU University Hospital, LMU Munich and Asklepios Lung Clinic Gauting, Munich, Germany.
Gökce YavuzDivision of Thoracic Surgery, LMU University Hospital, LMU Munich and Asklepios Lung Clinic Gauting, Munich, Germany.
Fuad DamirovDivision of Thoracic Surgery, LMU University Hospital, LMU Munich and Asklepios Lung Clinic Gauting, Munich, Germany.
Niels ReinmuthDepartment of Thoracic Oncology, Asklepios Lung Clinic Gauting, Munich, Germany.
Martina MerkDepartment of Thoracic Oncology, Asklepios Lung Clinic Gauting, Munich, Germany.
Rudolf A HatzDivision of Thoracic Surgery, LMU University Hospital, LMU Munich and Asklepios Lung Clinic Gauting, Munich, Germany.
Amanda TufmanDepartment of Internal Medicine V, LMU University Hospital, LMU Munich, Germany.
Christian P SchneiderDivision of Thoracic Surgery, LMU University Hospital, LMU Munich and Asklepios Lung Clinic Gauting, Munich, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundsLung cancer patients often have multiple comorbidities. This study aimed to determine which comorbidities had an impact on all-cause mortality in lung cancer patients who had undergone surgical treatment.

methodsThis retrospective study reviewed data from all lung cancer patients who underwent lobectomy or segmentectomy at the Lung Cancer Center Munich between 2011 and 2020. We compared numerical outcomes between patients with minimally invasive surgery and patients with thoracotomy using t-test, and categorical outcomes using Chi2-test or fishers exact test when cell counts were < 6. We used multivariate Cox Regression to model the association between comorbidities and overall survival.

results1658 patients (556 minimally invasive,1102 thoracotomy) were included. Across the entire population the comorbidity with the strongest association to death was chronic lymphatic leukemia (HR = 5.15, p = < 0.001), followed by pulmonary fibrosis (HR = 4.06, p = < 0.001), mild liver disease (HR = 2.18, p = 0.02), peripheral arterial disease (HR = 1.48, p = 0.04) and chronic obstructive pulmonary disease (HR = 1.42, p = < 0.01). In the minimally invasive surgery group chronic lymphatic leukemia was most strongly associated with death (HR = 14.31, p = 0.01). This was followed by mild liver disease (HR = 5.01, p = 0.01) and myocardial infarction (HR = 2.45, p = 0.04). Whereas in the thoracotomy group the strongest associations were fibrosis (HR = 4.20, p = < 0.001) and COPD (HR = 1.51,p = < 0.01).

conclusionMost of the comorbidities analyzed do not have a major impact on all-cause mortality after lung surgery. Those that do have a high impact tend to have a very low prevalence.

Indexed as

Carcinoma, Non-Small-Cell LungLung NeoplasmsPneumonectomyAgedCause of DeathComorbidityFemaleHumansMaleMiddle AgedMinimally Invasive Surgical ProceduresRetrospective StudiesThoracotomyComorbiditiesComorbidomeNon-small cell lung cancerSurgeryThoracotomyVideo-assisted thoracoscopic surgery

Identifiers

PMID40615841
PMCPMC12226845

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.